TY - JOUR
T1 - Shorter laboratory turnaround time is associated with shorter emergency department length of stay
T2 - a retrospective cohort study
AU - Vrijsen, Bram E L
AU - Haitjema, Saskia
AU - Westerink, Jan
AU - Hulsbergen-Veelken, Cornelia A R
AU - van Solinge, Wouter W
AU - Ten Berg, Maarten J
N1 - Funding Information:
The authors wish to thank Mark de Groot for his help with the data acquisition.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12/21
Y1 - 2022/12/21
N2 - BACKGROUND: A longer emergency department length of stay (EDLOS) is associated with poor outcomes. Shortening EDLOS is difficult, due to its multifactorial nature. A potential way to improve EDLOS is through shorter turnaround times for diagnostic testing. This study aimed to investigate whether a shorter laboratory turnaround time (TAT) and time to testing (TTT) were associated with a shorter EDLOS.METHODS: A retrospective cohort study was performed, including all visits to the emergency department (ED) of an academic teaching hospital from 2017 to 2020 during which a standardized panel of laboratory tests had been ordered. TTT was calculated as the time from arrival in the ED to the ordering of laboratory testing. TAT was calculated as the time from test ordering to the reporting of the results, and was divided into a clinical and a laboratory stage. The outcome was EDLOS in minutes. The effect of TTT and TAT on EDLOS was estimated through a linear regression model.RESULTS: In total, 23,718 ED visits were included in the analysis. Median EDLOS was 199.0 minutes (interquartile range [IQR] 146.0-268.0). Median TTT was 7.0 minutes (IQR 2.0-12.0) and median TAT was 51.1 minutes (IQR 41.1-65.0). Both TTT and TAT were positively associated with EDLOS. The laboratory stage comprised a median of 69% (IQR 59-78%) of total TAT.CONCLUSION: Longer TTT and TAT are independently associated with longer EDLOS. As the laboratory stage predominantly determines TAT, it provides a promising target for interventions to reduce EDLOS and ED crowding.
AB - BACKGROUND: A longer emergency department length of stay (EDLOS) is associated with poor outcomes. Shortening EDLOS is difficult, due to its multifactorial nature. A potential way to improve EDLOS is through shorter turnaround times for diagnostic testing. This study aimed to investigate whether a shorter laboratory turnaround time (TAT) and time to testing (TTT) were associated with a shorter EDLOS.METHODS: A retrospective cohort study was performed, including all visits to the emergency department (ED) of an academic teaching hospital from 2017 to 2020 during which a standardized panel of laboratory tests had been ordered. TTT was calculated as the time from arrival in the ED to the ordering of laboratory testing. TAT was calculated as the time from test ordering to the reporting of the results, and was divided into a clinical and a laboratory stage. The outcome was EDLOS in minutes. The effect of TTT and TAT on EDLOS was estimated through a linear regression model.RESULTS: In total, 23,718 ED visits were included in the analysis. Median EDLOS was 199.0 minutes (interquartile range [IQR] 146.0-268.0). Median TTT was 7.0 minutes (IQR 2.0-12.0) and median TAT was 51.1 minutes (IQR 41.1-65.0). Both TTT and TAT were positively associated with EDLOS. The laboratory stage comprised a median of 69% (IQR 59-78%) of total TAT.CONCLUSION: Longer TTT and TAT are independently associated with longer EDLOS. As the laboratory stage predominantly determines TAT, it provides a promising target for interventions to reduce EDLOS and ED crowding.
KW - Diagnostic Techniques and Procedures
KW - Emergency Service, Hospital
KW - Hospitals, Teaching
KW - Humans
KW - Length of Stay
KW - Retrospective Studies
KW - Clinical laboratory techniques
KW - Hospital emergency services
KW - Length of stay
UR - http://www.scopus.com/inward/record.url?scp=85144564024&partnerID=8YFLogxK
U2 - 10.1186/s12873-022-00763-w
DO - 10.1186/s12873-022-00763-w
M3 - Article
C2 - 36544114
SN - 1471-227X
VL - 22
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 1
M1 - 207
ER -